BIOMED 10/21b Motor Dev 1

Question 1

development themes

Answer 1

1. variability
   - expected in young children, but not expected to be the exact same way
2. range of typical development
   - range of when it is typical to develop skills
   - interplay o how the child is developing and their environment
3. Multiple factors impact motor skill acquisition

Question 2

milestone acquisition

Answer 2

1. enviroment and exposure
2. musculoskeletal
3. predisposition

Question 3

developmental domains

Answer 3

1. sensory
2. cognitive
3. motor
4. communication

Question 4

how should children respond to sensory stimuli in developmental domains?

Answer 4

1. Taste, touch, sound, feel, see

2. Able to respond in the same way as other children their age

Question 5

what are some issues children may have with cognitive developmental domains

Answer 5

Difficulties reading and writing

Question 6

what are gross motor patterns

Answer 6

larger motor patterns (PT)

Question 7

what are fine motor patterns

Answer 7

handwriting and drip (OT)

Question 8

rate of development

Answer 8

children from different areas, looked at skills via assessment
-all bands overlap and progress with similar

Question 9

gestational age

Answer 9

time from first date of last menstrual period of mother to the time of birth

• Use in neonatal setting (NICU)
• Need to look at gross motor as if the patient was still in the womb

Question 10

promenstrual age

Answer 10

period of time from last day of menstrual period to the date of assessment

Question 11

chronogical age

Answer 11

age on calendar at term and full term

Question 12

adjusted age

Answer 12

depends on when the child was born in relation to the date of assessment

Question 13

when is a preterm delivery?

Answer 13

<37 weeks

Question 14

when is a late preterm delivery

Answer 14

34-36 weeks

Question 15

what are interventions with late preterm delivered patients?

Answer 15

keep them warm
encourage parents and caregivers for touch and care of the child
ventilatory support

Question 16

what does it mean to have a very preterm delivery

Answer 16

<32 weeks

Question 17

how long is a normal full term pregnancy?

Answer 17

37-42 weeks

Question 18

neonate

Answer 18

1. Gross Motor
						◊ Limited
						◊ Physiological flexion
						◊ Reflexive movements (expect palmar flexion, volitional control is limited)
					2.  Fine Motor
						◊ Not purposeful
						◊ Limited ability to self-soothe
						◊ Dependent for feeding
					3. Communication
						◊ Cries to communicate needs

Question 19

first 3 months

Answer 19

1. Gross Motor
   ◊ Consistently turn head to clear airway (safety)
   ◊ Increased head control when held
   ◊ Increased ability to lift the head (extension and rotation)
   ◊ Range of motion is increasing, but flexion remains (hip and knee)
2. Fine Motor
   ◊ Emerging ability to bring head to mouth
   ◊ Visual regard develops (tracking)
   ◊ Decreasing arm flexion position
   ◊ Involuntary release
   3. Communication
   ◊ Cries to communicate needs

◊ Bonding with caregivers

Question 20

3-6 months

Answer 20

1. Gross Motor
   ◊ Rolling emerges (prone to supine, then supine to prone)
   ◊ Good head control in supported sit, independent sitting around 5 months
   ◊ + traction with pull to sit
   } Tuck chin and pull up to sit
   ◊ Props onto forearms
   ◊ Antigravity kicking
   2. Fine Motor
   ◊ Hands to midline - purposeful reaching
   ◊ Can grasp a toy
   ◊ May bring hands to feet
   } Improved abdominal abilities
   ◊ Improving ability to self-soothe
   ◊ Weightbearing through the hands by end of this period
   3. Communication
   ◊ Cries to communicate needs, but increase in vocalizations
   ◊ Smiles
   ◊ Laughs

Question 21

7-9 months

Answer 21

1. Gross motor
						◊ Belly crawling > creeping on hands and knees
						◊ Improved sitting balance reactions
						◊ Sit with trunk rotation
					2.  Fine motor
						◊ Consistent self-feeding
						◊ Bimanual play in sitting
						◊ Improved grasp patterns and dexterity
					3. Communication 
						◊ Increasing repertoire of sounds
						◊  responds to name
						◊ Responds to no

Question 22

10-12 months

Answer 22

1. Gross Motor
   ◊ Pulling to stand and cruising on furniture
   ◊ Emerging independent standing
   ◊ Some children are walking
   2. Fine Motor
   ◊ Improving release and in-hand manipulation
   ◊ Can use a cup
   ◊ Practices with a spoon
   ◊ Pokes a toy to manipulate cause-effect
   3. Communication
   ◊ Vocalizations are consistent for certain items/needs
   ◊ Repetitive consonant combinations, emerging words

◊ Can provide an object when asked (Give me the cup)

Question 23

12-18 months

Answer 23

1. Gross Motor
   ◊ Walking
   ◊ Transitioning floor to stand
   ◊ Altering speed without loss of balance
   ◊ Time since ambulation more indicative of function and quality of movement than age
   2. Fine Motor
   ◊ Controlled release of an object
   ◊ Trap a ball and roll a ball back (sit)
   ◊ Self-feeding and use of utensils
   ◊ Holds a crayon in a fist (thumb up) and scribble
   3. Communication
   ◊ Understands simple requests
   ◊ Identifies 3+ body parts
   ◊ Separation distress
   ◊ About 10-15 words
   ◊ Receptive language > Expressive language

Question 24

18-24 months

Answer 24

1. Gross Motor
   ◊ - Increased development of gait pattern
   ◊ - Emerging run
   ◊ - Stair mobility: creep à standing with railing/ hand held
   2. Fine Motor
   ◊ Improving grip with drawing tools
   3. Communication
   ◊ - Two-part commands
   ◊ - Understands multiword combination (Daddy running)
   ◊ - 50-200 words
   ◊ - Says “NO” more often

Question 25

2 year olds

Answer 25

1. Gross Motor ◊ Negotiates stairs with marking time pattern (foot over foot) à ascending with alternating feet 2. Fine Motor ◊ - Holds a crayon in fingers ◊ - Vertical and horizontal stroke are imitated 3. Communication ◊ - Two-part phrases ◊ - 250+words ◊ - Responds to another child who is upset ◊ - Pretend play

Question 26

3 year olds

Answer 26

``` 1. Gross motor ◊ - Descends stairs with alternating pattern ◊ - Consistent jumping 2. Fine Motor ◊ - Assisted tooth brushing ◊ - Donning and doffing clothes ◊ - Can draw a circle 3. Communication ◊ - Complete sentences emerge ◊ - Improving grammar and syntax ◊ - May use physical aggression > verbal if upset or frustrated ```

Question 27

4 year olds

Answer 27

1. Gross Motor ◊ - Hops ◊ - Gallops consistently ◊ - Emerging skip ◊ - Overhand throw with rotation 2. Fine Motor ◊ - Cuts with scissors ◊ - Copies a square and crossed line ◊ - Emerging use of buttons ◊ - Copies letters and may reverse some 3. Communication ◊ - Poses questions ◊ - Recognizes written name and letters ◊ - Correct word arrangement to negate a term

Question 28

5 year olds

Answer 28

``` 1. Gross Motor ◊ Inconsistent jumping jacks ◊ Emerging forward roll ◊ Can complete an obstacle course with fair accuracy ◊ May still need help on swings ◊ Rides a bike 2. Fine motor ◊ Dynamic tripod grasp ◊ Improving writing endurance ◊ Transition from structured line cues to free writing in class 3. Communication ◊ May understand some words spelled aloud ```

Question 29

6 year olds

Answer 29

``` 1. Gross motor ◊ Skips ◊ Rides a bike without training wheels ◊ Can rollerskate 2. Fine motor ◊ Can don a coat and zip it without assistance to start the zipper 3. Communication ◊ Understands humor ◊ Understands homonyms ```

Question 30

Milestones

Answer 30

1. Prone Tolerance 2. Supine Skills 3. sitting/supported sitting skills 4. standing skills 5. transition from floor to stand skills

Question 31

Prone Positioning tolerance

Answer 31

1. ability to turn head and clear airway 2. cervical extension (45 degrees by 2 months, 90 degrees by 4 months) 3. rolling prone to supine 4. swimming 5. prone on extended forearms 6. belly crawling 7. creeping on hands and knees

Question 32

supine skills

Answer 32

``` Physiological flexion Maintains head in midline Hands to midline (3-4 months) Hands to knees then feet Feet to mouth Pull to sit without head lag, volitional control Rolling supine to prone ```

Question 33

sitting skills

Answer 33

Dependent for head and trunk control Supported with rounded spine (2-3 months), (+) head control Prop sitting (4-5 months) Sitting with hands free (5-6 months) - initially with wide BOS, then decreases Sitting and reaching unilaterally Sitting with bimanual play Sitting with trunk rotation Independently transitions into and out of sitting

Question 34

standing skills

Answer 34

Reflexive standing and stepping Positive weight acceptance (4 months +) Pull to stand, but can’t eccentrically control descent Stands at external support surface Cruising Standing with 1, then 2 hands free in high guard Static standing and assisted walking Independent walking Independently transitions floor to stand without external support surface

Question 35

floor to stand transitions

Answer 35

Pull to stand Floor to stand through 3-point or bear stance Floor to stand through ½ kneel with upper extremity support Floor to stand through ½ kneel with hands free May still have a preferred method of transferring through ½ kneel/ dominant manner of transferring

Question 36

what is a reflex?

Answer 36

An involuntary response to a stimulus. Monosynaptic or polysynaptic, short-range or long-range, uni or bilateral, symmetrical or asymm. Old views: Motor control emerges from reflexes that are nested within hierarchically organized levels of the CNS. In development, early on lower level reflexes are present, then higher level reflexes/more cortical control develops.

Question 37

how important are reflexes?

Answer 37

Previously given more focus than we currently do, based on understanding of neuroscience and motor control Some standardized assessments still use them in determining age-equivalents Residual presence of one is more telling than the normal emergence and integration of reflexes You may also may see primitive reflexes with neurological insult later in life

Question 38

what is the significance of reflexes?

Answer 38

Developmental level and neural functioning could be somewhat explained Obligatory or persistent reflexes may be indicative of atypical development. Familiarizes you with the basic developmental model used in medicine and by most pediatricians.

Question 39

what are the limitations of reflexes?

Answer 39

Motor abilities are influenced by many factors beyond reflex maturation (mechanics, motivation, and environment). Reflex theories assume CNS as the primary agent of developmental change. Treatment focused on inhibiting primitive reflexes and promoting higher level reflexes is a narrow view of early intervention.